Risk factors for delirium in patients with COVID-19: A systematic review and meta-analysis

[Display omitted] •A meta-analysis was conducted to investigate risk factors for delirium in COVID-19 patients.•There is no increased risk of delirium in COVID-19 patients with hypertension, COPD, ARDS.•Hydrocortisone and azithromycin use may increase the risk of delirium.•Medications for COVID-19 should be administered with caution to reduce the risk of developing delirium.•Risk factors should be addressed early to minimize delirium severity. Delirium is one of the serious neurological complications of Coronavirus Disease 2019 (COVID-19) and is associated with significant morbidity and mortality in patients with COVID-19, especially in older patients. There is currently no meta-analysis of risk factors for delirium in patients with COVID-19. This study aimed to identify potential risk factors for delirium in patients with COVID-19 through a meta-analysis of observational clinical studies. In conducting this analysis, literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science, and study quality was assessed using the Newcastle-Ottawa Quality Scale (NOS). Data were extracted independently by two reviewers and pooled using either fixed effects or random effects models based on the results of heterogeneity testing. As a result of this meta-analysis, a total of 21 studies were included, including 10,147 patients. The analysis revealed the identification of 26 predisposing factors and 54 precipitating factors associated with COVID-19-related delirium. Notably, the administration of hydrocortisone and azithromycin, among other specific medications designated for COVID-19, exhibited a potential to be positively associated with the incidence of delirium in patients afflicted with COVID-19. In conclusion, the present study identified potential predisposing and precipitating factors linked with delirium in COVID-19 patients. It is anticipated that these results will have a considerable impact on the management and treatment of delirium in COVID-19 patients.